Keywords

Depression, treatment resistance, Brain stimulation

Summary

According to current treatment guidelines, both antidepressant pharmacotherapy and psychotherapy are recommended for patients suffering from major depression. However, about 20-25% of patients do not respond or respond insufficiently to standard treatment approaches. In treatment resistant cases, today electroconvulsive therapy (ECT) is considered safe and effective and thus the treatment of choice. Meanwhile, there is also a large body of evidence for antidepressant action of repetitive transcranial magnetic stimulation (rTMS) and, to a lesser extent for transcranial direct current stimulation (tDCS). Also studies on the effects of vagus nerve stimulation (VNS) and deep brain stimulation (DBS) have yielded promising results.